Dr Koren welcomes delegates to the 11th FACE Research Roundtable and briefly describes some of the new and promising research to be presented throughout the day.

A Message from the Honourable Mary Polak

Speaker: Mary Polak, Minister, BC Ministry of Children and Family Development

Minister Mary Polak describes British Columbia's collaborative
approach and 10 year plan for FASD prevention, assessment, diagnosis and intervention, and notes that "a strong system of support is accomplished through strong partnerships."

The WA FAS DPN clinical and MRI databases were utilized to construct comprehensive clinical profiles of all 1,400 WA State residents (birth through adult) who received an interdisciplinary FASD diagnostic evaluation using the FASD 4-Digit Diagnostic Code at one of the 7 WA FAS DPN clinics in the first 13 years (1993-2005) of operation. A recent publication (Astley, 2010) demonstrates the broad array of clinical, research, and public health questions that can be addressed with a FASD clinical/research dataset.

Established in September 2007, the Canadian Foundation on Fetal Alcohol Research (CFFAR), is an independent, non-profit foundation created to promote interest and fund research related to the short and long-term bio-medical, psychological and social effects of alcohol consumption during pregnancy, and the prevention of FASD. CFFAR awards research grants annually in conjunction with International FASD day and the annual FACE Research Roundtable.

In a landmark project of the Canadian Association of Paediatric Health Centres (CAPHC), the Public Health Agency of Canada and Health Canada, nearly 100 experts from across Canada have developed a national Screening Tool Kit for Fetal Alcohol Spectrum Disorder (FASD). This new Tool Kit is set to become a powerful aid in the prevention, early diagnosis, and management of FASD.

Introduction to NeuroDevNet

Speaker: Dan Goldowitz, Ph.D Canadian Research Chair, Tier 1 in Developmental Neurogenetics
University of British Columbia

NeurodevNet is a Canada-wide initiative dedicated to studying brain development. This new national research network includes experts in clinical treatment, genetics, brain imaging, knowledge translation, informatics, and neuroethics. FASD is one of the conditions targeted for research by NeurodevNet participants.

Fetal ethanol exposure and postnatal epilepsy: the tip of the neurobehavioural iceberg

Our group hypothesized that prenatal ethanol exposure could lead to a higher incidence than normal of epilepsy in the population with FASD. A retrospective review was conducted on all active charts (n=1063) at St. Michael's Hospital, Toronto and Glenrose Rehabilitation Hospital, Edmonton FASD clinics. Applying strict exclusion criteria left us with 425 subjects with a diagnosis of FASD. Twenty-five individuals had a confirmed diagnosis of epilepsy, and 50 had at least one documented seizure episode, yielding an overall prevalence of 17.7% in this population. We suggest that novel brain hyperexcitability dependant on gap junctional communication, underlies the marked neurobehavioural abnormalities in the FASD population and deserves further study to understand its basic mechanisms, so as to devise appropriate treatment strategies.

Maternal drinking guide to identify women at risk of alcohol use in pregnancy

This presentation describes new national standards of care for the screening and recording of alcohol use and counseling on alcohol use by women of child-bearing age and pregnant women based on the most up-to-date evidence. Consensus guidelines were developed with support by the Public Agency of Canada and the Society of Obstetricians and Gynaecologists of Canada.

Atypical hippocampal activation during associative recognition in children with FASD

The hippocampus is particularly vulnerable to the teratogenic effects of prenatal alcohol exposure. We have found reduced volumes and widths, altered chemical composition, and microstructural changes in the hippocampi of children with FASDs. Abnormal structure does correlate with memory performance, however the aim of this study was to more directly examine hippocampal function during memory retrieval using fMRI. Results show more diffuse frontal and greater bilateral hippocampal activation in children with FASDs compared to controls.

Neurobiological effects of prenatal alcohol exposure and stress: a potential pathway to increased vulnerability to substance use problems

There is a strong relationship between stress and substance use problems, and the neurobiological mechanisms underlying this relationship are becoming better understood. Importantly, prenatal alcohol exposure (PAE) alters the activity and regulation of the stress system and also results in an increased prevalence of substance use problems. However, how PAE may alter the interactions between stress and drug reward pathways is not known. Our research aims at examining whether or not alterations in stress responsiveness following PAE increase susceptibility to substance use problems later in life, and if so, what the mechanisms underlying this relationship are. Novel results will be presented and discussed.

Fatty acid ethyl esters (FAEE) in meconium have been established as sensitive and specific biomarkers of gestational alcohol exposure. While associations between meconium FAEE and several neurodevelopmental outcomes have been reported, an association between meconium FAEE and FASD diagnosis has yet to be made in Canadian children. This study serves to follow-up children, tested at birth for prenatal alcohol exposure, with comprehensive neurodevelopmental assessment by an FASD diagnostic team to determine the predictive value of meconium FAEE for FASD.

Neuroimaging cognitive function in children diagnosed with ARND and ADHD

Children with alcohol related neurodevelopmental disorders (ARND) do not demonstrate the facial features characteristic of FAS, but have neurocognitive or behavioural abnormalities. Children with ARND and ADHD have similar attentional problems, resulting in difficulties in diagnosis. Functional magnetic resonance imaging of children (10-14 years) diagnosed with ARND, ADHD and typically developing controls using tasks of working memory, response inhibition, and attention show areas of brain function that may be useful in discriminating between these groups.

Placental formic acid and folic acid after alcohol exposure: two sides to the story

Formic acid, the toxic metabolite of methanol, has been detected in cord blood of infants exposed to alcohol during pregnancy. Folic acid is required for detoxification of formic acid. Our preliminary results show that folic acid transfer to the fetus is decreased in pregnancies with chronic alcohol exposure. Altered folic acid levels may leave the fetus and placenta more vulnerable to the toxic effects of formic acid. Placental handling and toxicity of formic acid and methanol in the presence and absence of folic acid will be discussed.

An examination of the abilities, risks, and needs of adolescents and young adults with FASD in the criminal justice system: a research update

This study examines the psycholegal capacities, risks for justice system involvement and other adverse outcomes including mental health problems and victimization of youth age 12-23 with an FASD diagnosis. This presentation will provide an overview of the study goals, methodologies, and an update on early results. We will devote attention to the extensive preparatory stages undertaken with community partners to make this project possible, and discuss the challenges navigated to-date.

Announcement of 2010 FACE Scientific Poster Competition Winners

Best Student Poster: Using C. Elegans as a High Throughput Model of FASD to Delineate the Effects of Different Patterns of Embryonic Ethanol Exposure, Conny Y. Lin, University of British Columbia

Best Student Poster: Differentiating Restless Legs Syndrome (RLS) as a Cause of Circadian Sleep Rhythm Disorders in Children with FASD: Video Studies in the Home Setting - Commercially Available Low-Cost Equipment, Forson Chan, University of British Columbia

Best Poster Award for Original Research: National FASD Screening Tool Development Project: The Maternal Drinking Guide, Moumita Sarkar, The Motherisk Program, Hospital for Sick Children, Toronto